As most everyone knows, medicine is not an exact science. Every patient and every family must be treated individually. We all recognize that many things have the possibility of not going perfectly, especially when an ill child presents to the hospital. I am lucky enough to be a part of many families’ experiences at the hospital that go so well that you want to tell people about them. Goodness knows, there ...

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Recently I was the only witness to testify against local medical marijuana legislation.  The bill, already endorsed by all members of the Council of the District of Columbia, would allow use of marijuana for “any condition for which treatment with medical marijuana would be beneficial, as determined by the patient’s physician.”  As I waited hours for my turn to highlight the medical evidence about marijuana’s health effects, I sat silently, taking in ...

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The mission creep of maintenance of certification Up until 1988, being board certified in pediatrics was a voluntary process of passing the board exam once in a career. The American Board of Pediatrics (ABP) apparently realized this process didn’t make them much money, so in 1989, they abruptly ended “lifetime certification” and required an open book test and the associated fee every seven years.  I was in pediatric residency during this maintenance of certification ...

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I have made several observations as to why developmentally challenged people are losing out in our health care systems. Given that there are 11 million children in the United States with an emotional, developmental or behavioral condition, we really can’t afford to neglect this important issue. My first observation is that primary care remains a chronically undervalued component of health care delivery in the U.S. Despite the 60 million Americans who ...

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I flunk as a parent. I have no plans for my youngest kids this summer. The older ones are working. But the 13-year-old and 8-year-old, the ones at the formative stages of their academic and skill development (if you believe what everyone says), are doing squat. No camp. No enriching activities. No special trips. Well, we do rent a house at the beach for two weeks every summer, that's something, but ...

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Stop calling nurse practitioners mid level providers I really hate it when a nurse practitioner is called a mid-level provider. "Mid-level provider" isn’t even a legal or academic term. It is slang developed to demean or minimize a health professional, who is not an MD. The term "mid-level provider” is primarily aimed at nurse practitioners (NPs) as well as physician assistants (PAs) and mid-wives. It is insulting to health professionals ...

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In just a few days I’ll be leaving the clinic where I’ve practiced pediatrics for the past six years. The last months have been a flurry of last visits with families, paperwork, and tying up loose ends. There have been many, many goodbyes. I’ve been deeply moved by the expressions of gratitude and affection that many families have shared with me. It seems it is always in these times of change ...

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A couple of weeks ago, my family was traveling out of town. I was driving and my wife and almost 2-year-old daughter were buckled up in the back seat playing with some toys. My wife pulled out a brand new container of Play-Doh. As my daughter was preparing to pull the lid off to see what was inside, I drove through a section on the interstate where there was a ...

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It was an ordinary summer day.  People were milling on the main thoroughfare, bikes zig-zagging through traffic, cafés and pubs spilling onto the sidewalk, patrons sipping their way through a lazy Friday afternoon. We were ordinary that day too.  Just another family, managing the hectic jumble of kids’ lessons, bills, our careers, endless streams of birthday parties, too little sleep and the occasional date night out. But it was all shattered with ...

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“Is it weird that I cut myself on purpose?” A 14-year-old girl from a local middle school asked me this question at work last week. In my years as a Teen Xpress counselor, I have been asked about self-injurious behaviors many times. They ask: “What is it about?” “Isn’t it just a way to get attention?” “Why would someone do that?” “Are they trying to kill themselves?” It’s not only teens that ask about self-injury. I’ve ...

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